Periodontal disease (or periodontitis) is a set of inflammatory diseases affecting the periodontium, which are the tissues that surround and support the teeth. Periodontitis affects nearly 50% of the U.S. population and is a risk factor for cardiovascular disease. It involves progressive loss of the alveolar bone around the teeth, and if left untreated, can lead to the loosening and subsequent loss of teeth. Periodontitis is caused by microorganisms that adhere to and grow on the tooth's surfaces, and is exacerbated by an over-aggressive immune response against these microorganisms. A diagnosis of periodontitis is established by radiographic examination and by inspecting the soft gum tissues around the teeth with a probe to determine the amount of bone loss around the teeth.
Bone loss leading to periodontitis is preceded by soft tissue detachment from the teeth, and subsequent formation of pockets around the affected teeth ranging in depth from 4-10 mm. One of the hallmarks of successful therapy for periodontitis is resumption of healthy pocket depths of 1-3 mm. The method used to measure the depth of the pockets before and after therapy has remained relatively unchanged for over 75 years. The dentist inserts a thin metal periodontal probe, marked in mm, at 6 sites around each tooth between the tooth and gum until the probe stops. This diagnostic procedure, called periodontal probing, is uncomfortable for the patient. The probing depth numbers are recorded by an assistant, yielding 192 numbers per visit for a patient with complete dentition. To these numbers are added the level of gingival recession, recorded from the edge of the gingiva to the cement-enamel junction (CEJ), to determine the attachment loss around these 192 sites per patient, for a total of 384 readings per patient visit. The pressure exerted during probing by different dentists and at different appointments can differ considerably, inadvertently leading to variability in recorded numbers. Overall, this important oral health care procedure is time consuming, requires two operators, is variable, and is uncomfortable to the patient. New methods for measuring the depth of dental pockets are needed.
Therefore, it is an object of the invention to provide a method of imaging pockets between teeth and soft tissue, that is appreciably more precise, reproducible, rapid, and less labor intensive than traditional periodontal probing.
It is another object of the invention to provide dental filler formulations of tailorable radiopacity.
It is another object of the invention to provide a method of imaging pockets between teeth and soft tissue that is painless to the patient.
It is another object of the invention to provide three-dimensional images of the shapes and volumes of pockets for more accurate diagnoses and assessments of treatments.
It is another object of the invention to provide dental filler formulations that are anti-microbial or anti-inflammatory.
It is another object of the invention to provide dental filler formulations that are therapeutic with regards to periodontitis or peri-implantitis.